| Randy D Visser Do Pc | |
|
4282 Sw 43rd St Redmond OR 97756-6976 | |
| (541) 420-9482 | |
| (541) 323-3794 |
| Full Name | Randy D Visser Do Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4282 Sw 43rd St, Redmond, Oregon |
| Authorized Official Name and Position | Randy Dale Visser (OWNER) |
| Authorized Official Contact | 5414209482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy D Visser Do Pc Po Box 520 Redmond OR 97756-0111 Ph: (541) 420-9482 | Randy D Visser Do Pc 4282 Sw 43rd St Redmond OR 97756-6976 Ph: (541) 420-9482 |
| NPI Number | 1720498389 |
|---|---|
| Provider Enumeration Date | 05/05/2014 |
| Last Update Date | 12/29/2020 |
| Medicare PECOS PAC ID | 9133345465 |
|---|---|
| Medicare Enrollment ID | O20140723000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720498389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18333 (Oregon) | Primary |
| Provider Name | Randy D Visser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801859574 PECOS PAC ID: 5496731507 Enrollment ID: I20040629000390 |
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